We're going to do a bill. We hope that we don't have to do it with Democrats, but if we have to, we will.

SEN. JOHN THUNE, R-S.D.: Nothing has really changed in terms of the basic elements of this propos al. They have tried to figure out a way to wrench it into a budget window that somehow makes it look like it costs less, but at the end of the day, it actually costs more than the Senate Finance Committee bill.

(END VIDEO CLIP)

BRET BAIER, HOST: Well, we now have the Senate bill: The Democrats' version is 2,078 pages long. This Saturday they need 60 votes to move it forward to the Senate floor, so if they get past that hurdle, if they do, they can start debate on the bill after Thanksgiving.

As you look at the latest poll numbers, Quinnipiac has a poll out about President Obama's handling of healthcare — 53 percent disapprove, 41 percent approve.

We're here with the panel to breakdown of the Senate bill: Fred Barnes, executive editor of The Weekly Standard; A.B. Stoddard, associate editor of The Hill, and syndicated columnist Charles Krauthammer.

Fred, what about this bill?

FRED BARNES, EXECUTIVE EDITOR, THE WEEKLY STANDARD: Well, if you were a government bureaucrat you would think they designed this bill just for me. That's what it does. It gives the government a lot more power and their panels or commissions or commissioners and so on.

If you're a doctor or a patient, you're going to have less power. Patients now will have less choice than you get when you go to Starbucks to buy coffee. They're going to have very little choice.

And then there are up couple of other things: One of the tricks they have used, of course, that are pretty transparent that they have used to make the bill look like it actually will reduce the deficit. Now Bret, if you believe it is going to reduce the deficit, I've got a few things I'd like to sell you.

And of course they took out the doctor's fix and that saved them, what $210, $220 billion? And then they have the taxing and the so-called spending cuts, which they may or may not actually cut, go for 10 years, but the benefits only go for five years. When you get to the second 10 years, then of course it costs so much more. And that's pretty transparent.

But here's the hard part: Anything in this bill is going to be hard to change because you're going to need 60 votes if you want to change the part about abortion or if you want to get rid of the public option. It is going to be hard.

And Republicans are not going to help. They are not going to let this bill be improved because they think at the end of the day it will be an awful bill anyway. Why should we make it nicer so a few of the more moderate Democrats will vote for it? They don't want to vote for it.

BAIER: A. B. They move the spending to 2014, but when the program actually goes into effect — the taxes goes into effect in 2011.

One thing about the Congressional Budget Office's assessment that Senator Reid has touted again and again as being a good thing, on page nine they say that the public plan that's in there would typically have premiums that were somewhat higher than the average premiums for the private plans in the exchanges.

In other words: The public plan that's offered in this plan would cost more than the private plans. I don't get it. Wasn't the purpose to drive down premium costs?

A. B. STODDARD, ASSOCIATE EDITOR, THE HILL: Right, well there was actually a CBO score from a few weeks ago saying on the House side that their public plan might also do the same.

I think it's important to know for Senate Democrats the most important thing is that they got a good score from the Congressional Budget Office. And Fred and others who quibble whether or not it's deficit neutral...

(CROSSTALK)

BARNES: Quibble?

STODDARD: I just want to make a point that politically, timing, we all know on November 19, they would be nowhere without this score. They literally could not move. They could not get going. They're up against serious deadlines here and they want to get this done before 2010.

I do think in the end that in order to get 60 Democrats onboard, including Senator Byrd, who is in frail health, and get this out the door, I think the abortion restrictions are going to be strengthened. I think the public option will be weakened and I think that's how they get everyone onboard.

I don't know how that's going to happen...

BAIER: Because now, let me interrupt you, Democrat Ben Nelson told us, our producer up there, that he would join a filibuster of the bill once it gets to the floor if the abortion coverage is not changed.

STODDARD: Exactly, but he is willing to allow the public option to go forward hoping it might get pulled later. Mary Landrieu is willing to proceed with a vote to proceed, but she says the public option must go later.

So this talk that we're not hearing in back rooms has to do with the two topics. I think the abortion restrictions get tightened, much to the chagrin of the liberal left of the Democratic Party. I think the public option gets weakened as well.

BAIER: Charles?

CHARLES KRAUTHAMMER, SYNDICATED COLUMNIST: Where do you start? This is a really unbelievable bill.

As Fred indicates, because the numbers hand — because the provisions that the CBO looked at are so jiggered, even though CBO's numbers are real, it's about an unreal assumption.

If you start with 2015, which is essentially where the benefits start, and you go into the future, every 10 years you will have a plan that is not $800 billion, it's going to be $1.5 trillion. Which means that except for the early years, in which there are no benefits paid out and a lot of taxes paid in, you're going to have a huge net deficit which will probably be around half a trillion every decade.

Secondly, even if you had the revenue neutrality, which you won't, everybody assumes, well, that is going to help us economically. In fact, to achieve revenue neutrality, you have to increase taxes and you're going to have spending cuts.

Those increases in taxes in cuts and spending, are now not available in reducing the other deficits outside of health care which are going to amount to $9 trillion over the next decade.

So you create a new entitlement. You support it with new taxes and spending cuts, which you cannot now use in reducing the outside — the other deficits — which are destroying the dollar and the federal budget.

BAIER: And A. B., there are some hidden taxes that we kind of discovered in this thing: The botox tax that was laughed out of the negotiations in the Senate Finance Committee is in this bill. There's the payroll tax that a lot of people are concerned about the economy. It's interesting that this stuff made it back into this bill.

STODDARD: Well, they have to find a way to pay for the bill and so they put in — to increase the Medicare payroll tax and to start finding new sources of revenue is a way for Harry Reid, the majority leader, to get away from the taxes on these Cadillac plans, which labor unions oppose.

And I think as you look at a merging of a House and Senate bill, you're going to see more of these new taxes on the wealthy and less of taxes on plans because they really need to give labor something in this very tough year.

BARNES: I don't mean to quibble, if you can just forget these numbers. When you get into these health care plans as they have done in several states, what happens is the spending, it costs two or three times more times more than they had ever dreamed of. It happens with Medicare, it happens with Medicaid, it happens everywhere. So the CBO numbers are really irrelevant.

And for Harry Reid to say they're saving Medicare, it reminded me of, remember in Vietnam, Charles, you'll remember this, where the army explained they burned down the village and they said they had to destroy the village to save it.

He will destroy Medicare.

BAIER: Last word, quickly.

KRAUTHAMMER: Of all the ways in which you can raise revenue, in the Reid bill it's done with raising the payroll tax in the middle of a recession with over 10 percent unemployment exactly at a time when you want to encourage employment and lower the payroll tax. It's perverse.

BAIER: We haven't even talked about the states' opting-out option and how that's all going to work, but we will, guarantee you.

The administration seems to be backing off controversial new guidelines about breast cancer screening. The panel will discuss this after the break.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

HEALTH AND HUMAN SERVICES SECRETARY KATHLEEN SEBELIUS: Do what you've always done: Talk to your doctor, figure out your own health situation with your doctor, your family history. Those are the really important ingredients.

REP. MARSHA BLACKBURN, R-TENN.: This is how rationing began. This is the little toe in the edge of the water. And this is where you start getting a bureaucrat between you and your physician.

And as we have gone through this health care debate over the past several months, this is what we have warned about.

(END VIDEO CLIP)

BAIER: What are they talking about there? The recommendation by a federal task force — federally appointed task force — that women should not undergo a routine mammogram until the age of 50.

Well, the White House and specifically through the health and human services secretary backed away, saying that this is just a recommendation. It's an independent panel. It does not mean that this is coverage or will make policy.

What about this, the politics of it and the science of it? We're back with the panel.

A. B., we'll start with you.

STODDARD: I think it's been a very tough week for the government. I think it was hard for the Obama administration facing a fight on their hands over whether or not they are resisting an investigation into the killings at Fort Hood; whether or not there were 700 incidents reported by the recovery.gov site of grants that were actually never provided to phantom congressional districts.

And now they are just disowning recommendations that are so important to women on this very important topic, trying to urge in the middle of the health care reform debate that we not follow these new guidelines issued by a government panel.

It is true that the government panel doesn't include any breast cancer expertise and perhaps should not have been making those who argue the substance of the recommendations.

But it is very interesting moment for the Obama administration to tie to distance itself from a government panel and those recommendations, fearing that this will impact the health care reform debate and it will show people in 3D just what a government takeover of their health care could actually look like.

BAIER: Which was the congresswoman's point there, Fred, about lifting the veil on these task forces.

BARNES: This is actually what Sarah Palin was talking about when she referred to "death panels": In other words panels that are unelected, unaccountable officials whose recommendations would be enforced by the government.

And these would have been — they would have embraced these if it hadn't been for the huge flap by patients and doctors, you know. And not just whacko doctors and people at tea parties or anything like that, but the doctors at Massachusetts General and so on, really a significant part of the medical community that rebelled at these.

When you think of what would have happened this week, though, if the Obama administration had gotten its way: No hearings in Congress on the Fort Hood hearing — the Fort Hood killing; the stimulus.

The press has exposed all this stuff: The press has done a great job of exposing all the phony claims of jobs created by the stimulus. And then of course this panel, this would have become policy absent the huge adverse reaction to it in public.

(CROSSTALK)

BAIER: I want to point out there are some normal doctors who go to the tea parties. Charles?

KRAUTHAMMER: People are reacting as if we never had a panel or a recommendation before. Years before, we had a recommendation from a panel like this who said start at forty. Every day the FDA is deciding this new drug is a good one or not, and if it's not, you don't ever see it.

So it is not as if these kinds of independent commissions don't exist and determine what we get and what we don't. So it's, the issue here is not panels in general or recommendations in general; it's the recommendation in and of itself.

BAIER: We had some doctors on the air today who said this is also about a woman who spends a month terrified when she gets a false positive. There's, you know, speaking up for the task force recommendations. And what what's your thought on that?

KRAUTHAMMER: I read the paper and the report that came out of it and its recommendation is based not on the cost, the financial cost, but on the benefits, the net benefits.

And the problem here is a mammogram is extremely inexact: One in 10 tests which are returned as cancer are not, so you have a 10 percent false positive, which causes not just anxiety and suffering, but new tests, more radiation, even a procedure, and perhaps other harms, which could come.

And the balance of this is how much of that is worth how many of the real cancers that are caught.

So when you have inexact tests and inexact screenings, you have got to make a determination and decide how to balance them, and I think the report is a fairly good recommendation. It's not aimed at saving money. It would, but that's not what its recommendations are based on.

BAIER: But do you think it is the start of rationing?

KRAUTHAMMER: Absolutely. It is the way it will happen in the future.

BAIER: But you're not opposed to it?

KRAUTHAMMER: Look, we ration all the time, as the FDA does, and in Britain it is done by a medical commission and government imposition. Here it happens all the time in what insurance will support and what it doesn't.

It's not new.

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